Transposition of the Great Arteries

Transposition of the Great Arteries is a topic covered in the Select 5-Minute Pediatrics Topics.

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Basics

Description

Abnormal anatomic relationship between the great arteries and the ventricles in which the aorta arises from the anatomic right ventricle and the pulmonary artery arises from the anatomic left ventricle

Incidence

Incidence is 20–30 per 100,000 live births, with a 60–70% male predilection.

Prevalence

Transposition of the great arteries represents up to 7% of all cases of congenital heart disease.

Pathophysiology

  • Systemic and pulmonary circulations are separated and function in parallel.
  • Desaturated systemic venous blood is ejected from the right heart to the aorta, whereas the oxygenated pulmonary venous blood is ejected from the left ventricle into the lungs.
  • Degree of hypoxemia depends on amount of intercirculatory mixing (patent ductus arteriosus [PDA], patent foramen ovale [PFO], ventricular septal defect [VSD]).
    • Degree of left-to-right shunting is the effective systemic blood flow, whereas right-to-left shunting determines effective pulmonary flow.

Commonly Associated Conditions

  • PDA and PFO with intact ventricular septum (50%)
  • VSD (40%)
  • Posterior malalignment VSD with left ventricular outflow tract obstruction (e.g., subpulmonic stenosis, pulmonary stenosis, pulmonary atresia) (10%)
  • Anterior malalignment VSD with right ventricular outflow tract obstruction (e.g., subaortic stenosis, aortic stenosis, coarctation of the aorta or interruption of the aortic arch) (10%)
  • Leftward juxtaposition of the atrial appendages (5%)
  • Straddling of the atrioventricular valve

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Citation

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TY - ELEC T1 - Transposition of the Great Arteries ID - 14058 Y1 - 2015 PB - Select 5-Minute Pediatrics Topics UR - https://im.unboundmedicine.com/medicine/view/Select-5-Minute-Pediatric-Consult/14058/all/Transposition_of_the_Great_Arteries ER -